OSTEOPOROSIS

Guidelines For Prevention

At
The Primary Health Care Level

A. Guidelines for Screening for

Osteoporosis
B. Guidelines for Detection and
Treatment of Underlying Causes
of Osteoporosis
C. Guideline for Health Education

A. Guidelines for Screening for

Osteoporosis
o Screening:

Is the systematic application of the

test when it is assumed that people
have no symptoms.

Recommendations for Osteoporosis screening:

- Osteoporosis is common, costly associated with high morbidity and
mortality
- Easily detectable and highly treatable
- DEXA is safe screening test
- Patients can be started on treatment and counselled regrading lifestyle changes

Osteoporosis screening at
PHC

High risk or selective

screening

?Whom to refer for DEXA

All Men and Women 60
years and over

?Whom to refer for DEXA

Postmenopausal women
Men 50-59 years
With one or more of the following:

Fragility fracture after age 40 years

Vertebral fracture or low BMD identified on X-ray
Parental hip fracture
High alcohol intake
Current smoking
Low body mass index (less than 18.5 kg/m2)
High risk medication use: i.e. prolonged
glucocorticoid use)
Rheumatoid arthritis
Other disorders that lead to bone loss

?Whom to refer for DEXA

Men and women < 50 years
With one or more of the following:

Hypogonadism
Fragility fracture
High risk medication use
Rheumatoid arthritis
Chronis inflame conditions
Cushing disease
malabsorption syndrome
Uncontrolled hyperthyroidism
Primary hyperthyroidism
Other disorders associated with rapid
bone loss/ fracture

Hospitals Providing DEXA

Scan
Inside Riyadh City
King Saud Medical City
King Salman Hospital
Alimam AbdulRahman Elfaisal

Hospital

Outside Riyadh City:

King Khalid Hospital Elmajmaa
Eldawadmi Hospital

B. Guidelines for Detection and

Treatment of Underlying Causes of
Osteoporosis
Screen for and manage the following
conditions:
Rheumatoid arthritis
Hypogonadism
Chronis inflammatory conditions
Cushing disease
Malabsorption syndrome
Primary hyperthyroidism
High alcohol intake
Current smoking

C. Guidelines for Health

Education
Target population:
All PHC users at all ages

Subjects:
Bone-healthy diet
Physical Exercise

Bone-healthy diet
Provide Health education on the following:

Children (1 18 years)

Adults (19 50
years)

The recommended vitamin D

allowance for adults aged 10 50
is 600 IU per day

Elderly ( 50 and
above)

Physical Exercise

Prevention
Initiatives should be directed at the following
measures:
Optimize nutrition in the youth to achieve high
peak bone mass.
Encourage adequate intake of calcium and
Vitamin D.
Identify and treat subjects with Vitamin D
deficiency, especially children, females in the
reproductive age group, and the elderly.
Recommend regular weight bearing exercise.
Avoidance of tobacco smoking and excessive
alcohol intake.

Prevention
Assess every postmenopausal woman for

risk of osteoporosis, and determine the

need for diagnostic tests and
prevention /treatment.
Early treatment of causes of osteoporosis
[e.g. thyrotoxicosis, smoking,
hyperparathyroidism, others].
Prevention and early treatment of
osteoporosis of patients who are receiving
high dose steroid therapy, or other drugs
that contribute to osteoporosis.

Resources
International Osteoporosis Foundation

http://www.iofbonehealth.org/
Saudi Guidelines for Osteoporosis Prevention
and Treatment 2014
Guidelines for Prevention and Management of
Osteoporosis in Adults at KFSH&RC -2003
2015 Guidelines for Osteoporosis in Saudi
Arabia: Recommendations from the Saudi
Osteoporosis Society. Ann Saudi Med 2015;
35(1): 1-12